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Maximus Federal Services, Inc. fax number

(916) 606-4270

Independent Medical Review (IMR) Operations (IMRO)

Used for: Submission of IMR applications for California Division of Workers' Compensation Independent Medical Review

Fax destination details

Department
Independent Medical Review (IMR) Operations (IMRO)
Purpose
Submission of IMR applications for California Division of Workers' Compensation Independent Medical Review
Form
DWC IMR Application Form (IMR) / IMR Application — Application for Independent Medical Review (DWC-IMR)
Address
Maximus Federal Services, Inc., P.O. Box 138009, Sacramento, CA 95813-8009
Voice phone
1-855-865-8873

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Sign and date the IMR application; consent to obtain medical records; include a copy of the written utilization review decision; mail or fax the documents to Maximus within the deadline. Refer to the official IMR instructions for complete filing requirements and deadlines.

Official form instructions are published as a downloadable file on the organization's website.

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